Provider Demographics
NPI:1083918973
Name:BARNES, KATHERINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 BRICKWAY BLVD
Mailing Address - Street 2:SANTA ROSA VA PHARMACY
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8226
Mailing Address - Country:US
Mailing Address - Phone:707-569-2380
Mailing Address - Fax:707-569-2361
Practice Address - Street 1:3841 BRICKWAY BLVD
Practice Address - Street 2:SANTA ROSA VA PHARMACY
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-8226
Practice Address - Country:US
Practice Address - Phone:707-569-2380
Practice Address - Fax:707-569-2361
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54262183500000X, 1835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy